%0 Journal Article %A Michael Fiechter %A Cathérine Gebhard %A Tobias A. Fuchs %A Jelena R. Ghadri %A Julia Stehli %A Egle Kazakauskaite %A Bernhard A. Herzog %A Aju P. Pazhenkottil %A Oliver Gaemperli %A Philipp A. Kaufmann %T Cadmium-Zinc-Telluride Myocardial Perfusion Imaging in Obese Patients %D 2012 %R 10.2967/jnumed.111.102434 %J Journal of Nuclear Medicine %P 1401-1406 %V 53 %N 9 %X We have evaluated the impact of increased body mass on the quality of myocardial perfusion imaging using a latest-generation γ-camera with cadmium-zinc-telluride semiconductor detectors in patients with high (≥40 kg/m2) or very high (≥45 kg/m2) body mass index (BMI). Methods: We enrolled 81 patients, including 18 with no obesity (BMI < 30 kg/m2), 17 in World Health Organization obese class I (BMI, 30–34.9 kg/m2), 15 in class II (BMI, 35–39.9 kg/m2), and 31 in class III (BMI ≥ 40 kg/m2), including 15 with BMI ≥ 45 kg/m2. Image quality was scored as poor (1), moderate (2), good (3), or excellent (4). Patients with BMI ≥ 45 kg/m2 and nondiagnostic image quality (≤2) were rescanned after repositioning to better center the heart in the field of view. Receiver-operating-curve analysis was applied to determine the BMI cutoff required to obtain diagnostic image quality (≥3). Results: Receiver-operating-curve analysis resulted in a cutoff BMI of 39 kg/m2 (P < 0.001) for diagnostic image quality. In patients with BMI ≥ 40 kg/m2, image quality was nondiagnostic in 81%; after CT-based attenuation correction this decreased to 55%. Repositioning further improved image quality. Rescanning on a conventional SPECT camera resulted in diagnostic image quality in all patients with BMI ≥ 45 kg/m2. Conclusion: Patients with BMI ≥ 40 kg/m2 should be scheduled for myocardial perfusion imaging on a conventional SPECT camera, as it is difficult to obtain diagnostic image quality on a cadmium-zinc-telluride camera. %U https://jnm.snmjournals.org/content/jnumed/53/9/1401.full.pdf